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ICD-10 Guide
ICD-10 CodesK68.2

K68.2

Billable

Retroperitoneal fibrosis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K68.2 is a billable code used to indicate a diagnosis of retroperitoneal fibrosis.

Key Diagnostic Point:

Retroperitoneal fibrosis is a rare condition characterized by the formation of fibrous tissue in the retroperitoneal space, which can lead to obstruction of the ureters and other vital structures. Clinically, patients may present with abdominal or flank pain, renal impairment, and urinary symptoms due to ureteral obstruction. The condition can be idiopathic or secondary to medications, infections, or malignancies. The anatomy involved primarily includes the kidneys, ureters, and surrounding vascular structures. Disease progression can lead to significant renal dysfunction if left untreated, necessitating timely intervention. Diagnostic considerations include imaging studies such as CT or MRI, which can reveal the extent of fibrosis and any associated complications. Laboratory tests may also be performed to assess renal function and rule out other causes of symptoms. Early diagnosis and management are crucial to prevent irreversible damage to the urinary system.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and differential diagnosis to confirm
  • Treatment complexity: May involve surgical intervention or corticosteroid therapy
  • Documentation requirements: Detailed clinical history and imaging reports are essential
  • Coding specificity: Requires accurate coding to differentiate from other abdominal conditions

Audit Risk Factors

  • Common coding errors: Misclassification with other abdominal conditions
  • Documentation gaps: Incomplete imaging or clinical notes
  • Billing challenges: Potential denials due to lack of clear diagnosis or treatment documentation

Specialty Focus

Medical Specialties

Primary medical specialty: Urology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Retroperitoneal fibrosis can significantly impact patient health by leading to renal impairment and increased healthcare utilization due to complications. Understanding the epidemiology of this condition is crucial, as it is often underdiagnosed. Quality measures should focus on timely diagnosis and intervention to improve patient outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Retroperitoneal fibrosis can significantly impact patient health by leading to renal impairment and increased healthcare utilization due to complications. Understanding the epidemiology of this condition is crucial, as it is often underdiagnosed. Quality measures should focus on timely diagnosis and intervention to improve patient outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the case and the necessity of procedures such as ureteral stenting or surgical intervention. Common denials may arise from insufficient documentation or lack of clear medical necessity. Coders should ensure that all relevant information is included in the medical record to support the billed services and reduce the risk of audits.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K68.2?

K68.2 specifically covers retroperitoneal fibrosis, which may be idiopathic or secondary to other conditions such as malignancies or certain medications. It is essential to document the underlying cause if known.

When should K68.2 be used instead of related codes?

K68.2 should be used when there is a confirmed diagnosis of retroperitoneal fibrosis, particularly when imaging studies support the diagnosis and other conditions have been ruled out.

What documentation supports K68.2?

Documentation should include imaging reports (CT or MRI), clinical symptoms, laboratory results indicating renal function, and any relevant medical history that may contribute to the diagnosis.